Partner Notification

MANAGEMENT SUMMARY
Sexual history
Introduce concept of partner notification by asking about number of sexual contacts in past 2 months.
Are these contacts regular or casual? (Be mindful that the term partner may imply a relationship.)
Are they able to contact these people? (Notifying all contacts may not be possible, e.g. if there insufficient information or a
threat of violence.)
Document number of contacts clearly in the notes you may not be the one following-up partner notification.

Positive test result

For chlamydia, gonorrhoea, trichomoniasis and syphilis, or contact of non-specific urethritis, pelvic inflammatory disease (PID)
or epididymo-orchitis [partner notification (PN) not required for herpes simplex virus (HSV) and human papilloma virus (HPV)].
Note: Consultation with sexual health or infectious diseases physicians is required for the management of all cases of syphilis.

Identify who needs to be contacted based on sexual history

How many of these people does the patient have contact details for?
What contact details do they have for these people?

Simple case
Safety or confidentiality issues?

NO: PATIENT REFERRAL YES: PROVIDER REFERRAL

(Patient informs sexual contacts recommended method.) (Clinician informs sexual contacts with patient consent.)
Note: If violence is likely then may be better not to
notify contacts.

Discuss with client how they are going to notify

contact(s)
Face-to-face (this is the most popular method) Obtain details of contact(s) to be notified
Telephone Discuss confidentiality with index case, however
Text explain that contacts may be able to identify them.
Partner notification card
Email

Consult with sexual health service if required

Contact details of New Zealand sexual health services
Provide education, support and resources to assist located at www.nzshs.org.
patients, based on their chosen method:
Factsheets on infection and partner notification with
appropriate websites for further information.
Partner notification cards. Notify contacts anonymously
Role play telling their partner if appropriate. Advise they have been named as a contact of the
specific infection.
Do not give name of index client.
Advise them to attend for sexual health check and
Follow-up (phone or in person) 1 week later treatment.
All notifiable contacts informed? Advise them where they can attend for this
If unable to notify contacts ask why and offer support GP, sexual health or family planning clinic.
and appropriate resources.
Check no unprotected sex with untreated contacts
will need re-treatment if re-exposed.
Advise retest for infection in 3 months.
Document in notes.

Further guideline information www.nzshs.org or phone the local sexual health service.
For further partner notification information refer to Australasian Contact Tracing Manual http://ctm.ashm.org.au.

This Best Practice Guide has been produced by NZSHS, and is adapted from the CMDHB Best Practice Guideline.
Every effort has been taken to ensure that the information in this guideline is correct at the time of publishing (July 2012).

Produced with funding by the Ministry of Health

Partner Notification Management Guidelines page 1 of 3

 Partner Notification MANAGEMENT GUIDELINES

Definition
The process where the sexual contacts of individuals diagnosed with a sexually transmitted infection are identified and notified of
their potential exposure to an infection with the aim of those contacts attending a health professional for assessment, treatment and
education. This process is also commonly referred to as contact tracing.

Which infections require partner notification and

how far back to trace
Refer to specific infection guidelines for more detailed information re recommended look back intervals.

Infection Timeframe how far back to trace

Chlamydia 2 months

Gonorrhoea 2 months

Syphilis Referral to specialist advised

Epididymo-orchitis 2 months

Pelvic inflammatory disease 2 months

Urethritis 2 months

Trichomoniasis 2 months

HIV Referral to specialist advised

It is not necessary to perform partner notification for genital warts or genital herpes.

Who should do the partner notification?

Patient versus provider referral
Patient referral
Patient is advised by a health professional to notify their sexual contacts of their potential exposure to an STI and encourage them to
attend for screening and treatment.

Advantages
More popular with both patients and health professionals.
Less resource intensive.

Disadvantages
Relies on self-report that contacts have been notified and treated.
Can be less effective than provider referral if not enhanced with support and resources for the patient and health professional.
Note: Patient referral is by far the most common way that partner notification is managed.

Provider referral
Health care professional elicits contact information from patients about their sexual contacts, notifies those contacts that they may
have been at risk of acquiring an STI and recommends that they are screened and treated for that infection.

Advantages
Confidentiality method of choice when an individual fears a violent reaction, and for certain situations and conditions.
May be appropriate for serious infections such as HIV and syphilis, where rigorous case finding is warranted.

Disadvantages
More time and resource intensive.

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Barriers and predictors of successful patient referral
partner notification
Barriers
Stigma associated with STIs
Casual partners
Multiple partners
Anonymous partners

Predictors
Patients self-efficacy
Relationship quality
Intention to notify at initial diagnosis
Having a regular partner.
Having only one partner

Enhancing patient referral partner notification

Enhancements to the patient referral process can improve the likelihood of sexual partners being identified and treated.
Education; providing resources such as STI fact sheets and partner notification cards, and an individualised approach have been
used successfully to enhance partner notification efforts.

Patient delivered partner therapy (PDPT)

Patient-delivered partner therapy, also known as expedited partner therapy, is the process whereby the patient delivers antibiotics to
their sexual contacts without the contact attending a consultation with a health professional.
This practice is not legal under current New Zealand prescribing law (Section 39 of the Medicines Regulations 1984).
There is no strong evidence that this practice improves outcomes over standard patient referral.

Tips for successful partner notification

Have partner notification permanently on your checklist for managing STIs.
Gain the cooperation of the patient through establishing rapport and being non judgemental.
Take a comprehensive sexual history, introducing the concept of partner notification pre-diagnosis by identifying potential sexual
contacts who will need to be notified in the case of a positive result.
Find out what partners are contactable and what contact details they have for them dont make assumptions, as sometimes
patients have limited contact details even for partners they consider regular.
Be mindful of language the word partner often implies a relationship. Seek clarification as required.
Explain what partner notification is.
Educate the patient about the STI. Inform them about asymptomatic infections, potential complications of untreated infection and
the possibility of re-infection if a sexual contact is not treated. Well-informed patients are more likely to inform sexual contacts.
Provide the patient with appropriate resources.
Dispel myths Just because you were tested first doesnt mean you had the infection first.
Remember to educate about safer sex practices If you use condoms every time you have sex you are much less likely to get
an STI.

Referral to a specialist sexual health service

is recommended for:
Conditions in which the practitioner lacks specific expertise, e.g. HIV or syphilis.
Complex cases.
Refer www.nzshs.org for local clinics.
For further partner notification information refer to Australasian Contact Tracing Manual http://ctm.ashm.org.au.

Further guideline information www.nzshs.org or phone the local sexual health service.

This Best Practice Guide has been produced by NZSHS, and is adapted from the CMDHB Best Practice Guideline.
Every effort has been taken to ensure that the information in this guideline is correct at the time of publishing (July 2012).

Produced with funding by the Ministry of Health

Partner Notification Management Guidelines page 3 of 3